Table 2.
Comparison of Predisposing, Enabling, and Need Characteristics of Medicare Beneficiaries Receiving a CMR by Community Pharmacists and Other Pharmacist Providers in 2014
| N=104,303 (100%) | |||||
|---|---|---|---|---|---|
| CMR Provided By: | |||||
| Community RPh n (%) |
Plan RPh n (%) |
p-value† | MTM Vendor In- House RPh n (%) |
p-value‡ | |
| Total Beneficiaries by Provider Status | 26,337 (25.3%) | 35,741 (34.3%) | 42,225 (40.5%) | ||
| Predisposing Variables | |||||
| Mean Age (SD) | 75 (6.8) | 75 (6.8) | 0.04 | 75 (6.9) | <0.001 |
| Male Gender | 9795 (37.2%) | 13,551 (37.9%) | 0.07 | 15,887 (37.6%) | 0.254 |
| Race | <0.001 | <0.001 | |||
| White | 18,767 (71.3%) | 24,922 (69.7%) | 32,322 (76.5%) | ||
| Black | 3012 (11.4%) | 4727 (13.2%) | 5296 (12.5%) | ||
| Asian | 512 (1.9%) | 1041 (2.9%) | 774 (1.8%) | ||
| Hispanic | 3743 (14.2%) | 4532 (12.7%) | 3227 (7.6%) | ||
| North American Native | 42 (0.2%) | 90 (0.3%) | 138 (0.3%) | ||
| Other/Unknown | 261 (1.0%) | 429 (1.2%) | 468 (1.1%) | ||
| Enabling Variables | |||||
| Urban Residence | 21,441 (81.4%) | 31,665 (88.6%) | <0.001 | 34,335 (81.3%) | 0.754 |
| Geographic Region | <0.001 | <0.001 | |||
| Northeast | 2217 (8.4%) | 4895 (13.7%) | 10,759 (25.5%) | ||
| South | 15,183 (57.6%) | 11,611 (32.5%) | 14,559 (34.5%) | ||
| Midwest | 5423 (20.6%) | 5943 (16.6%) | 9997 (23.7%) | ||
| West | 2520 (9.6%) | 12,338 (34.5%) | 6792 (16.1%) | ||
| Other | 994 (3.8%) | 954 (2.7%) | 118 (0.3%) | ||
| Income Enrollment Status | <0.001 | <0.001 | |||
| Dual Medicaid Enrollment | 4684 (17.8%) | 4711 (13.2%) | 7953 (18.8%) | ||
| Qualified Medicare Beneficiary | 1307 (5.0%) | 993 (2.8%) | 1482 (3.5%) | ||
| Specified Low-Income Medicare Beneficiary | 1282 (4.9%) | 963 (2.7%) | 1183 (2.8%) | ||
| No Low Income Subsidy Coverage | 19,064 (72.4%) | 29,074 (81.3%) | 31,607 (74.9%) | ||
| Copayment Status Indicator | <0.001 | <0.001 | |||
| Catastrophic Coverage During Year | 5779 (21.9%) | 5899 (16.5%) | 10,417 (24.7%) | ||
| Coverage Gap Exposure During Year | 10,589 (40.2%) | 14,639 (41.0%) | 15,605 (37.0%) | ||
| No Coverage Gap Exposure During Year | 9969 (37.9%) | 15,203 (42.5%) | 16,203 (38.4%) | ||
| Need Variables | |||||
| Cognitively Impaired | 1079 (4.1%) | 913 (2.6%) | <0.001 | 503 (1.2%) | <0.001 |
| Any Hospitalization | 2323 (8.8%) | 2175 (6.1%) | <0.001 | 5875 (13.9%) | <0.001 |
| Any ED Visit | 2658 (10.1%) | 2613 (7.3%) | <0.001 | 6761 (16.0%) | <0.001 |
| Mean Count of Hospitalization (SD) | 0.15 (0.6) | 0.09 (0.4) | <0.001 | 0.22 (0.7) | <0.001 |
| Mean Count of ED Visits (SD) | 0.19 (0.8) | 0.12 (0.5) | <0.001 | 0.27 (0.8) | <0.001 |
| Mean Number of Elixhauser Conditions (SD) | 0.63 (1.5) | 0.43 (1.2) | <0.001 | 1.01 (1.8) | <0.001 |
| Mean Elixhauser Mortality Weight (SD) | 1.02 (4.2) | 0.68 (3.5) | <0.001 | 1.67 (5.3) | <0.001 |
| Mean Therapeutic Drug Classes (SD) | 15.20 (5.2) | 14.42 (5.2) | <0.001 | 14.87 (5.0) | <0.001 |
| Specific Elixhauser Conditions | |||||
| Diabetes | 3097 (11.8%) | 2900 (8.1%) | <0.001 | 7733 (18.3%) | <0.001 |
| Hypertension | 3746 (14.2%) | 3875 (10.8%) | <0.001 | 10,101 (23.9%) | <0.001 |
| Congestive Heart Failure | 1253 (4.8%) | 947 (2.6%) | <0.001 | 2890 (6.8%) | <0.001 |
| Chronic Pulmonary Disease | 1492 (5.7%) | 1218 (3.4%) | <0.001 | 3297 (7.8%) | <0.001 |
| Depression | 587 (2.2%) | 404 (1.1%) | <0.001 | 1180 (2.8%) | <0.001 |
CMR = comprehensive medication review; ED = emergency department; MTM = medication therapy management; RPh = pharmacist; SD = standard deviation.
†
p-values represent comparisons using t-tests (continuous variables) or chi-square tests (categorical variables) between community pharmacist and plan pharmacist cohorts.
‡
p-values represent comparisons using t-tests (continuous variables) or chi-square tests (categorical variables) between community pharmacist and MTM Vendor In-house pharmacist cohorts.